Breastfeeding support in low and middle-income countries: Secondary analysis of national survey data

Small and nutritionally at-risk infants under six months, defined as those with wasting, underweight, or other forms of growth failure, are at high-risk of mortality and morbidity. The World Health Organisation 2013 guidelines on severe acute malnutrition highlight the need to effectively manage this vulnerable group, but programmatic challenges are widely reported. This review aims to inform future management strategies for small and nutritionally at-risk infants under six months in low- and middle-income countries (LMICs) by synthesising evidence on existing breastfeeding support packages for all infants under six months. We searched PubMed, CINAHL, Cochrane Library, EMBASE, and Global Health databases from inception to 18 July 2018. Intervention of interest were breastfeeding support packages. Studies reporting breastfeeding practices and/or caregivers’/healthcare staffs’ knowledge/skills/practices for infants under six months from LMICs were included. Study quality was assessed using NICE quality appraisal checklist for intervention studies. A narrative data synthesis using the Synthesis Without Meta-analysis (SWiM) reporting guideline was conducted and key features of successful programmes identified. Of 15,256 studies initially identified, 41 were eligible for inclusion. They were geographically diverse, representing 22 LMICs. Interventions were mainly targeted at mother–infant pairs and only 7% (n = 3) studies included at-risk infants. Studies were rated to be of good or adequate quality. Twenty studies focused on hospital-based interventions, another 20 on community-based and one study compared both. Among all interventions, breastfeeding counselling (n = 6) and education (n = 6) support packages showed the most positive effect on breastfeeding practices followed by breastfeeding training (n = 4), promotion (n = 4) and peer support (n = 3). Breastfeeding education support (n = 3) also improved caregivers’ knowledge/skills/practices. Identified breastfeeding support packages can serve as "primary prevention" interventions for all infants under six months in LMICs. For at-risk infants, these packages need to be adapted and formally tested in future studies. Future work should also examine impacts of breastfeeding support on anthropometry and morbidity outcomes. The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO 2018 CRD42018102795).

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Co-morbid anaemia and stunting among children of pre-school age in low- and middle-income countries: a syndemic

Public Health Nutrition ◽

10.1017/s136898001800232x ◽

2018 ◽

Vol 22 (1) ◽

pp. 35-43 ◽

Cited By ~ 6

Author(s):

Thach Duc Tran ◽

Beverley-Ann Biggs ◽

Sara Holton ◽

Hau Thi Minh Nguyen ◽

Sarah Hanieh ◽

...

Keyword(s):

Rural Areas ◽

Secondary Analysis ◽

Logistic Models ◽

Demographic And Health Surveys ◽

Healthy Children ◽

Middle Income ◽

Disadvantaged Children ◽

Middle Income Countries ◽

Co Morbidity ◽

Low And Middle Income

AbstractObjectiveTo determine the prevalence of co-morbidity of two important global health challenges, anaemia and stunting, among children aged 6–59 months in low- and middle-income countries.DesignSecondary analysis of data from Demographic and Health Surveys (DHS) conducted 2005–2015. Child stunting and anaemia were defined using current WHO classifications. Sociodemographic characteristics of children with anaemia, stunting and co-morbidity of these conditions were compared with those of ‘healthy’ children in the sample (children who were not stunted and not anaemic) using multiple logistic models.SettingLow- and middle-income countries.SubjectsChildren aged 6–59 months.ResultsData from 193 065 children from forty-three countries were included. The pooled proportion of co-morbid anaemia and stunting was 21·5 (95 % CI 21·2, 21·9) %, ranging from the lowest in Albania (2·6 %; 95 % CI 1·8, 3·7 %) to the highest in Yemen (43·3; 95 % CI 40·6, 46·1 %). Compared with the healthy group, children with co-morbidity were more likely to be living in rural areas, have mothers or main carers with lower educational levels and to live in poorer households. Inequality in children who had both anaemia and stunting was apparent in all countries.ConclusionsCo-morbid anaemia and stunting among young children is highly prevalent in low- and middle-income countries, especially among more disadvantaged children. It is suggested that they be considered under a syndemic framework, the Childhood Anaemia and Stunting (CHAS) Syndemic, which acknowledges the interacting nature of these diseases and the social and environmental factors that promote their negative interaction.

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Outcomes associated with anaesthetic techniques for caesarean section in low- and middle-income countries: a secondary analysis of WHO surveys

Scientific Reports ◽

10.1038/s41598-020-66897-8 ◽

2020 ◽

Vol 10 (1) ◽

Cited By ~ 1

Author(s):

Pisake Lumbiganon ◽

Hla Moe ◽

Siriporn Kamsa-ard ◽

Siwanon Rattanakanokchai ◽

Malinee Laopaiboon ◽

...

Keyword(s):

Caesarean Section ◽

Secondary Analysis ◽

Anaesthetic Techniques ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Microestimates of wealth for all low- and middle-income countries

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2113658119 ◽

2022 ◽

Vol 119 (3) ◽

pp. e2113658119

Author(s):

Guanghua Chi ◽

Han Fang ◽

Sourav Chatterjee ◽

Joshua E. Blumenstock

Keyword(s):

Survey Data ◽

Household Survey ◽

Heterogeneous Data ◽

Machine Learning Algorithms ◽

Middle Income ◽

Middle Income Countries ◽

Economic Development And Growth ◽

Household Survey Data ◽

Nationally Representative ◽

Low And Middle Income

Many critical policy decisions, from strategic investments to the allocation of humanitarian aid, rely on data about the geographic distribution of wealth and poverty. Yet many poverty maps are out of date or exist only at very coarse levels of granularity. Here we develop microestimates of the relative wealth and poverty of the populated surface of all 135 low- and middle-income countries (LMICs) at 2.4 km resolution. The estimates are built by applying machine-learning algorithms to vast and heterogeneous data from satellites, mobile phone networks, and topographic maps, as well as aggregated and deidentified connectivity data from Facebook. We train and calibrate the estimates using nationally representative household survey data from 56 LMICs and then validate their accuracy using four independent sources of household survey data from 18 countries. We also provide confidence intervals for each microestimate to facilitate responsible downstream use. These estimates are provided free for public use in the hope that they enable targeted policy response to the COVID-19 pandemic, provide the foundation for insights into the causes and consequences of economic development and growth, and promote responsible policymaking in support of sustainable development.

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An outcome-based definition of low birthweight for births in low- and middle-income countries: a secondary analysis of the WHO global survey on maternal and perinatal health

BMC Pediatrics ◽

10.1186/s12887-019-1546-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Malinee Laopaiboon ◽

Pisake Lumbiganon ◽

Siwanon Rattanakanokchai ◽

Warut Chaiwong ◽

João Paulo Souza ◽

...

Keyword(s):

Low Birthweight ◽

Secondary Analysis ◽

Perinatal Health ◽

Middle Income ◽

Global Survey ◽

Middle Income Countries ◽

Definition Of ◽

Low And Middle Income

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Effectiveness of interventions for dementia in low- and middle-income countries: protocol for a systematic review, pairwise and network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-027851 ◽

2019 ◽

Vol 9 (6) ◽

pp. e027851

Author(s):

Maximilian Salcher-Konrad ◽

Huseyin Naci ◽

David McDaid ◽

Suvarna Alladi ◽

Deborah Oliveira ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Secondary Analysis ◽

Routine Care ◽

Middle Income ◽

Middle Income Countries ◽

Cochrane Database ◽

Registration Number ◽

Meta Analyses ◽

Low And Middle Income

IntroductionThere are more people living with dementia in low- and middle-income countries (LMICs) than in high-income countries. Evidence-based interventions to improve the lives of people living with dementia and their carers are needed, but a systematic mapping of methodologically robust studies in LMICs and synthesis of the effectiveness of dementia interventions in these settings is missing.Methods and analysisA systematic review and meta-analysis will be conducted to answer the question: Which dementia interventions were shown to be effective in LMICs and how do they compare to each other? Electronic database searches (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, WHO Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit, Cochrane Database of Systematic Reviews) will be complemented by hand searching of reference lists and local knowledge of existing studies from an international network of researchers in dementia from LMICs. Studies will be eligible for inclusion if they were published between 2008 and 2018, conducted in LMICs and evaluated the effectiveness of a dementia intervention using a study design that supports causal inference of the treatment effect. We will include both randomised and non-randomised studies due to an anticipated low number of well-conducted randomised trials in LMICs and potentially greater external validity of non-randomised studies conducted in routine care settings. In addition to narrative synthesis of the interventions, feasibility of pairwise and network meta-analyses will be explored to obtain pooled effects of relative treatment effects.Ethics and disseminationSecondary analysis of published studies, therefore no ethics approval required. Planned dissemination channels include a peer-reviewed publication as well as a website, DVD and evidence summaries.Prospero registration numberCRD42018106206.

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Maternal morbidity and preterm birth in 22 low- and middle-income countries: a secondary analysis of the WHO Global Survey dataset

BMC Pregnancy and Childbirth ◽

10.1186/1471-2393-14-56 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 49

Author(s):

Joshua P Vogel ◽

Anne CC Lee ◽

João Paulo Souza

Keyword(s):

Preterm Birth ◽

Maternal Morbidity ◽

Secondary Analysis ◽

Middle Income ◽

Global Survey ◽

Middle Income Countries ◽

Low And Middle Income

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Stunting and Anemia in Children from Urban Poor Environments in 28 Low and Middle-income Countries: A Meta-analysis of Demographic and Health Survey Data

Nutrients ◽

10.3390/nu12113539 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3539

Author(s):

Shireen Assaf ◽

Christina Juan

Keyword(s):

Survey Data ◽

Health Survey ◽

Urban Poor ◽

Urban Poverty ◽

Demographic And Health Survey ◽

Child Malnutrition ◽

Middle Income ◽

Middle Income Countries ◽

Health Survey Data ◽

Low And Middle Income

Child malnutrition remains a global concern with implications not only for children’s health and cognitive function, but also for countries’ economic growth. Recent reports suggest that global nutrition targets will not be met by 2025. Large gaps are evident between and within countries. One of the largest disparities in child malnutrition within counties is between urban and rural children. Large disparities also exist in urban areas that have higher rates of child malnutrition in the urban poor areas or slums. This paper examines stunting and anemia related to an urban poverty measure in children under age 5 in 28 low and middle-income countries with Demographic and Health Survey data. We used the United Nations Human Settlements Programme (UN-HABITAT) definition to define urban poor areas as a proxy for slums. The results show that in several countries, children had a higher risk of stunting and anemia in urban poor areas compared to children in urban non-poor areas. In some countries, this risk was similar to the risk between the rural and urban non-poor. Tests of heterogeneity showed that these results were not homogeneous across countries. These results help to identify areas of greater disadvantage and the required interventions for stunting and anemia.

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